Objetivo: apresentar na língua portuguesa a terminologia, conceito e descrição dos estágios da lesão por pressão estabelecidos pelo National Pressure Ulcer Advisory Panel em 2016. Método: estudo descritivo, reflexivo do tipo ensaio teórico. Para nortear este estudo foi utilizado como matriz o resultado do consenso realizado pelo órgão americano em 2016. Resultado: o termo úlcera por pressão passou a ser denominado lesão por pressão, o conceito e a descrição dos estágios da lesão foram alterados. São apresentados detalhamentos das lesões classificadas em Estágio 1: Eritema não branqueável de pele intacta; Estágio 2: Perda de espessura parcial da pele com derme exposta; Estágio 3: Perda total da espessura da pele; Estágio 4: Perda total da espessura da pele e tecido; Lesão por Pressão não Estadiável: cobertura da perda total da espessura da pele e tecido; e Lesão por Pressão Tissular Profunda: vermelho escuro persistente não branqueável, descoloração marrom ou roxa. Descreve ainda as definições adicionais: Lesão por Pressão relacionada a Dispositivos Médicos e Lesão por Pressão em Membrana Mucosa. Conclusão: o National Pressure Ulcer Advisory Panel ampliou o conceito e acrescentou novas apresentações da lesão por pressão, informações que podem descrever melhor o comportamento de tais lesões.
BACKGROUND: Medical devices can cause pressure injuries. PURPOSE: This study was conducted to determine the prevalence of and factors associated with medical device-related pressure injury (MDRPI) in an intensive care unit (ICU). METHODS: A cross-sectional study was performed among adult patients (at least 18 years of age) admitted to an ICU in a referral hospital in Brazil between December 2019 and February 2020. The skin of patients who consented to participate was assessed for the presence of an MDRPI, and the use of all medical devices was noted. Other independent variables (sociodemographic variables, medical history, pressure injury risk factors, medications, and length of hospitalization) were abstracted from the medical records. Bivariate data analysis included Pearson’s chi-square test or Fisher’s exact test; odds ratio and a confidence interval of 95% also were established. Correlation among independent variables and MDRPI was determined using the ρ Spearman correlation test, and a hierarchical binary logistic regression analysis was performed using statistically significant variables from the bivariate analysis. P < .05 was considered statistically significant. RESULTS: The 125 study participants ranged in age from 15 to 97 years (mean, 63.02 ± 19.2), 76 (60.8%) were men, and 76 (60.8%) were White. Of the 125 participants, 43 (34%) experienced MDRPI; the total number of MDRPIs was 58 (3 patients had 3 injuries, and 7 patients had 2 injuries). Of those 58 MDRPIs, 46 were stage 1, and 12 were stage 2. Polypharmacy (> 4 medications) was a significant risk factor for MDRPI. Use of a nasal catheter, cord for orotracheal tube fixation, oximeter, intra-abdominal pressure equipment, and indwelling urinary catheter was significantly associated with the presence of MDRPI. Renal and respiratory diseases and the presence of infection were positively related to the presence of MDRPI. CONCLUSION: Medical device-related pressure injury was prevalent in this patient population. Most of these injuries were stage 1, which suggests that frequent monitoring and device repositioning (when possible) may help prevent more serious injuries. Additional research involving other hospitals in Brazil is needed to increase the understanding of the prevalence and risk factors of MDRPIs in patients in the ICU.
1 January 2020 in Revista Brasileira de Enfermagem
Objective: To describe the prevalence and factors associated with pressure injuries related to the use of personal protective equipment during the COVID-19 pandemic. Methods: Cross-sectional study conducted using an instrument made available in social networks with 1,106 health professionals. The data were analyzed using descriptive statistics and compared, considering pvalue < 0.05. Results: There was a prevalence of 69.4% for pressure injuries related to the use of personal protective equipment, with an average of 2.4 injuries per professional. The significant factors were: under 35 years of age, working and wearing personal protective equipment for more than six hours a day, in hospital units, and without the use of inputs for protection. Conclusion: Pressure injuries related to the use of medical devices showed a high prevalence in this population. The recognition of the damage in these professionals makes it possible to advance in prevention strategies.
Objective: to evaluate and relate quality of life at work and occupational stress in the nursing team in the Emergency Care Unit. Method: a cross-sectional, correlational study conducted with 109 nursing workers working in the Emergency Care Unit of Minas Gerais, Brazil. A questionnaire with demographic and labor profile was used; the occupational stress was verified by the Job Stress Scale, and the quality of life at work by the Walton model. Results: Among the 109 workers, 34.9% were nurses, 53.2% nursing technicians and 11.9% nursing assistants. In analyzing the Job Stress Scale, 14.7% characterize work with high demand, 8.3% active work, 40.4% passive work and 36.7% work with low demand. In assessing quality of life at work, 39.5% are dissatisfied and 60.5% satisfied. The factors associated with dissatisfaction with work, according to the global scale quality of life at work, were female gender, nurse, low support at work, high demand or active work and longer time in the position held. Conclusion: it was found that most nursing workers in the Emergency Care Unit are satisfied with their quality of life at work and exposed to moderately occupational stress, and those most exposed to this stress were dissatisfied with their quality of life at work.
1 June 2017 in Investigación y Educación en Enfermería